Virginia Academy of

Family Physicians

2017Annual Report

Table of Contents

2017 Annual Business Meeting Agendaand VAFP Vision and Mission Statements 42016-2017 Officers, Directors & Ex Officio Members 52017-2018 Nominees for Officers, Directors and AAFP & MSV Representatives 6Committee/Task Force/Political Action 7President’s Message 8-9Incoming President’s Message 10-11Legislative Update 12-15VAFP Career Center 15Membership 16VAFP Awards 17Finances 18-19Continuing Medical Education 20Practice Enhancement & Quality 21In Memoriam 21Residents and Students 22Past Presidents of the VAFP 23-24

I. Call to Order Lindsey D. Vaughn, MD, FAAFP VAFP PresidentII. Welcome and Introductions III. President’s ReportIV. Election of 2017-18 VAFP Officers and DirectorsV. Legislative Report Hunter Jamerson, JD, MBA VAFP General Counsel & Legislative ConsultantVI. Adjournment

2017 Annual Business MeetingAgenda

Virginia Academy of Family Physicians

VAFP Vision StatementThe vision of the VAFP is for Virginia to be the best place for our citizens to receive their healthcare and for family physicians to practice medicine.VAFP Mission StatementThe mission of the VAFP is to empower its members to be personalphysicians who provide high quality, accessible health care, dedicatethemselves to the well-being of the citizens of Virginia, and areguided by the principle that the family physician is the specialist ofchoice for lifelong health care.

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2016-2017 Officers, Directorsand Ex Officio MembersPRESIDENTLindsey D. Vaughn, MD, FAAFPSuffolkPRESIDENT ELECTRupen S. Amin, MD, MBA, FAAFP HarrisonburgFIRST VICE-PRESIDENTDelmas J. Bolin, MD, PhD, FAAFPRoanokeIMMEDIATE PAST PRESIDENTCharles O. Frazier, MD, FAAFPWilliamsburgTREASURERDena R. Hall, MDSuffolkSECRETARyRobert I. Elliott, MD, FAAFPHurtExECUTIVE VICE PRESIDENTMary Lindsay White, MHARichmond2017 DIRECTORSSusan D. Hundley, MDClarksvilleBrian K. Unwin, MD, FAAFPRoanokeMichelle E. Kingsbury, MD, FAAFPVirginia Beach2018 DIRECTORSJerome A. Provenzano, MDNewport NewsEmmeline C. Gasink, MD, FAAFPNewport NewsJ. Scott Litton, MD, FAAFPPennington Gap

2019 DIRECTORSDavid S. Gregory, MD, FAAFPLynchburgNeeta Goel, MDLeesburgDaniel F. McCarter, MDNellysfordAAFP DELEGATESSterling N. Ransone, Jr., MD, FAAFPDeltavilleJesus L. Lizarzaburu, MD, FAAFPGraftonAAFP ALTERNATE DELEGATESE. Mark Watts, MD, FAAFPVintonKent E. Willyard, MDNewport NewsMSV DELEGATELindsey D. Vaughn, MD, FAAFPSuffolkMSV ALTERNATE DELEGATERupen S. Amin, MD, MBA, FAAFP HarrisonburgEx OFFICIO MEMBERSBrian A. Dickens, DOSalemMichael P. Jeremiah, MD, FAAFPRoanokeAnton J. Kuzel, MD, FAAFPRichmondChristine C. Matson, MD, FAAFPNorfolkM. Norman Oliver, MDCharlottesville

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2017-2018 Nominees for Officers, Directors and AAFP & MSV RepresentativesPRESIDENT ELECTDelmas J. Bolin, MD, PhD, FAAFPRoanokeFIRST VICE PRESIDENTEmmeline C. Gasink, MD, FAAFPNewport NewsSECRETARyCharles O. Frazier, MD, FAAFPWilliamsburg2018 DIRECTORRobin N. Anderson, MDVirginia Beach2020 DIRECTORSAmber Fedin, DODanvilleJeffrey B. Roberts, MDRichmondSebastian Tong, MD, MPHRichmond

AAFP DELEGATESterling N. Ransone, Jr., MD, FAAFPDeltavilleAAFP ALTERNATE DELEGATEE. Mark Watts, MD, FAAFPVintonMSV DELEGATERupen S. Amin, MD, MBA, FAAFPHarrisonburgMSV ALTERNATE DELEGATEDelmas J. Bolin, MD, PhD, FAAFPRoanoke

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Committee Chairs

Task Force Chair

Political Action Committee Chair

CME/PROFESSIONAL DEVELOPMENTMitchell B. Miller, MD, FAAFPKurtis S. Elward, MD, MPH, FAAFPExECUTIVELindsey D. Vaughn, MD, FAAFPFINANCEDena R. Hall, MDHEALTH OF THE PUBLICChristine C. Matson, MD, FAAFPNOMINATINGRupen S. Amin, MD, MBA, FAAFPLEGISLATIVEJesus L. Lizarzaburu, MD, FAAFP

PRACTICE ENHANCEMENT & QUALITyKurtis S. Elward, MD, MPH, FAAFPAnton J. Kuzel, MD, MHPE, FAAFPRESIDENT, STUDENT & FACULTyEmmeline C. Gasink, MD, FAAFP

Graduate Medical EducationRoger A. Hofford, MD, CPE, FAAFP

FAMDOCPACSean W. Reed, MD

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President’s MessageLindsey D. Vaughn, MD, FAAFPSuffolkDear Colleagues, Representing the VAFP as its 70th President hasbeen one of the greatest privileges in my career as aFamily Physician and I am honored to have served theAcademy. I truly believe the mission to make Virginiathe best place to receive healthcare and for FamilyPhysicians to practice, continues to be the primaryfocus of, and advanced by, the VAFP. As we meet in Northern Virginia for the first timein many years, I look forward to getting together withmy fellow Family Physicians, spending time on the beautiful grounds of LansdowneResort and obtaining invaluable CME. Our last meeting at Wintergreen had great at-tendance and continues to be a favorite for many of our members. Wintergreen hasalso become a significant event where students and residents meet and develop as animportant part of the VAFP. I am indebted to our CME Chair, Dr. Mitch Miller, and our VAFP staff, who consis-tently provide high quality education to meet the needs of our members. I am alsograteful for our many members who continue to support VAFP education in a timewhen many other groups struggle. Legislatively, the VAFP has had another successful year. Our Academy is fortunateto have the leadership of Dr. Jesus Lizarzaburu, Hunter Jamerson, JD, and the Legisla-tive Committee. The VAFP was instrumental in helping to craft legislation in line withthe VAFP mission. While the rapid implementation was not ideal, the newly institutedVirginia Board of Medicine regulations on narcotic prescribing are a far better alter-native than the proposed legislation. The recently enacted Direct Primary Care legis-lation does not significantly alter how our members practice under that model. On anational level, the AAFP continues to advocate for us all. Please consider donating toboth the VAFP and AAFP Political Action Committee. If everyone donated $100 to theAAFP PAC, it would be the largest medical PAC in the country. Financially, thanks to our Treasurer Dr. Dena Hall, the Finance Committee and ourdedicated staff, the VAFP remains very sound. This year the Finance Committee hasworked to develop a strategic plan. This plan continues to provide a conservative ap-proach in maintaining the cash base as well as funds to operate during “lean” years. Inshort, the VAFP is well positioned to meet the future needs of our members while stillhaving one of the lowest dues requirements of all the chapters within the AAFP.

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The VAFP has been well represented nationally over the past year. Leadershipmembers attended the Southeastern Family Medicine Forum which is a regional or-ganization that collaborates on legislative issues. These legislative issues and manyothers were further developed at the AAFP’s Legislative Conference in October. TheVAFP sent delegates to the Medical Society of Virginia and the AAFP Congress of Del-egates. This year is extra special for the VAFP. Past President, Dr. Sterling Ransone, whocurrently serves on the AAFP Commission on Membership and Member Services, willrun for the AAFP Board of Directors and we should all work to support him. Most recently, the VAFP had a full contingency attend the AAFP National Confer-ence of Constituency Leaders (NCCL). The NCCL is designed to provide InternationalMedical Graduate, Women, LGBT, Minority and New Physicians a larger voice withinthe AAFP. That same meeting also includes chapter leaders and I find it humbling tolearn that issues we have in Virginia are not that different from our colleagues inAlaska and most other states. I always leave this meeting feeling invigorated from theenergy of our fellow leaders. I know of no other group that strives to be so inclusiveand I am incredibly hopeful for the future of family medicine. This year has not been without sadness. The VAFP lost a wonderful friend and ad-vocate in our General Counsel of many years, K. Marshall Cook, JD. Marshall had servedthe VAFP for over 20 years and was always very responsive to the needs of our Acad-emy. Fortunately, another trusted VAFP advocate, Hunter Jamerson, JD, has agreed tobe our new General Counsel and should serve us well in continuing Marshall’s goodwork. I hope that we have been successful this past year in having the VAFP serve as abeneficial resource to its members on the topics of MACRA and Physician Well-Being.While most family physicians in the state are employed and somewhat “insulated” fromMACRA, I remain concerned that Virginia’s small, independent practices will suffer a“negative payment adjustment.” It is predicted that in groups with under 10 providers,about half will receive a negative adjustment. The VAFP has attempted to provide help-ful and less confusing information for a program which is extremely complex. All I askis to stay informed. I would like to thank our Executive Vice President, Mary Lindsay White and theextremely helpful VAFP staff as well as the dedicated members that serve on the VAFPBoard of Directors. I am also very appreciative of my clinical partners who were gra-cious in my absences this past year. Most importantly, to my incredible wife Sue forher support this year. Sincerely, Lindsey

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Incoming President’s MessageRupen S. Amin, MD, MBA, FAAFPHarrisonburgDear Colleagues, As the 71st President of the Virginia Academy ofFamily Physicians, I would like to welcome you to Lans-downe Resort! Our chapter staff has worked very hardto create a robust CME experience coupled with manyadditional activities to keep you and your family enter-tained throughout the weekend. Whether you are hereto earn CME credits, discover new ideas that enhance pa-tient care, or just catch up with old friends, my hope isthat you leave this weekend rested and with a renewedenthusiasm for Family Medicine. As for myself, I am honored to serve the 3,408 members of the Virginia Academyof Family Physicians as President for this upcoming year. I am truly blessed to be ableto practice medicine in the state that I was born and raised. For the past 6 years I havebeen privileged to provide healthcare to citizens of Virginia. None of this would bepossible without the guidance of mentors that steered me down the path of FamilyMedicine and of course my family which has been a vital support system. The Virginia Academy is continually active and has many accomplishments to cel-ebrate. Our Academy members are often called upon by state leaders to represent thehealth interests of the citizens of the Commonwealth. Furthermore, our legislative ef-forts at the state level have been recognized nationally for advocating for Family Physi-cians and leading the charge on scope of practice issues. A great representation of ourgains is the fact that policymakers are beginning to understand the value of FamilyMedicine as evidenced by recent health care bills and our continued input on high pri-ority matters. While our Academy has continued to push Family Medicine forward,we have also renewed our commitment to the students and residents of the Common-wealth by contributing to Family Medicine Interest Groups and hosting Students/Res-idents at all of our conferences and board meetings. I for one remain encouraged byour successes and the future of Family Medicine. Taking the words of Heraclitus of Ephesus, the only thing that is constant ischange. The healthcare landscape is a good example of this principle. Even with recentgains for our specialty, the time is now for all of our members to advocate for FamilyMedicine and highlight the benefits and cost savings that primary care can deliver toa healthcare system. Looking beyond healthcare reform, Family Medicine Physicianswill play an integral role in discussions regarding our national primary care shortage,increasing regulations, and enhanced payer scrutiny to name a few. The next severalyears have the potential to be an incredible time of change for our specialty.

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At a chapter level, our board of directors and chapter committees are hard at workrepresenting Family Physicians in the Commonwealth of Virginia. Our Legislative committee is led by Jesus Lizarzaburu, MD and the VAFP’s GeneralCounsel Hunter Jamerson, JD, MBA. The legislative committee will once again be activethis winter as the Virginia General Assembly legislative session is expected to bringmany bills that could potentially change the way we practice medicine. Our Continuing Medical Education Committee led by Dr. Mitch Miller continuesto deliver high quality venues such as Lansdowne for our annual CME conference. Inaddition to our annual and winter conference, the committee works to stay ahead ofBoard Certification requirements and has been instrumental in hosting KSA/CSA andPart IV Module events throughout the year. Our Resident, Student and Faculty Affairs Committee led by Dr. Emmeline Gasinkhas worked over the past several years to enhance the role of our Students and Resi-dents throughout the state. The VAFP is committed to this cause and we hope to pos-itively influence the future Family Medicine Physicians of the Commonwealth. On aside note, if you see a student or resident at our meeting, please take a moment to in-troduce yourself. I remember how difficult it was deciding my next steps after resi-dency and any input you may provide could make a big impact in a student orresident’s life. I am also excited about our new officers and directors joining the VAFP Board.Drs. Roberts, Tong, Fedin, and Anderson bring a wealth of knowledge and experiencefrom various practice areas across the commonwealth. I would also like to thank Drs.Elliott, Hundley, Unwin, Matson, and Kingsbury for their service to the Board with aspecial thank you to our out-going president, Dr. Lindsay Vaughn who has done a re-markable job this past year and left big shoes to fill. We also have a fantastic staff madeup of Mary Lindsay White, Matt Schulte, Cheryl Modesto, Kristi Reynolds and KristieDuncan that remain invested in the well-being of our Academy. As you can see thereare a lot of individuals that are committed to the success of Family Medicine Physiciansthroughout the state with a lot of great work currently being done. We are thankful tohave such a dedicated group of individuals! This is an incredibly exciting time to be a Family Medicine Physician in this coun-try and I want to thank you, our members and Family Physicians of the Commonwealthfor the excellent care that you deliver on a daily basis. I am constantly reminded ofthe dedication and passion our specialty has for our craft on a daily basis and am hon-ored to call myself a Family Medicine Physician. In closing, I am enthusiastic and humbled to have the opportunity to serve as Pres-ident for the members of the Virginia Academy of Family Physicians.Sincerely,Rupen S. Amin, MD, MBA, FAAFP

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The 2017 General Assembly session focused heavily on legislation intended to ad-dress the Commonwealth’s opioid epidemic. VAFP worked tirelessly to support theappropriate practice of medicine in the context of the opioid epidemic while opposingoverreaching efforts to legislate the practice of medicine. VAFP also defended againstcontinuing attempts to encroach on family medicine’s scope of practice by mid-levelproviders. Additionally, VAFP successfully advanced legislation and funding for astatewide ER Care Coordination program in order to improve patient care, provide ad-ministrative efficiencies, and push patient information regarding ER encounters to theprimary care level. Below is a synopsis of key legislative items and budget amendments passed dur-ing the 2017 General Assembly session and signed into law by the Governor effectiveJuly 1st. LEGISLATION:

HB 2161/SB 1179 – Opioid Prescribing Workgroup

•Summary: Requires the Secretary of Health and Human Resources to convenea workgroup that shall include representatives of the Departments of BehavioralHealth and Developmental Services, Health, and Health Professions as well as repre-sentatives of the State Council of Higher Education for Virginia and each of the Com-monwealth's medical schools, dental schools, schools of pharmacy, physician assistanteducation programs, and nursing education programs to develop educational stan-dards and curricula for training health care providers, including physicians, dentists,optometrists, pharmacists, physician assistants, and nurses, in the safe and appropriateuse of opioids to treat pain while minimizing the risk of addiction and substance abuse.The workgroup shall report its progress and the outcomes of its activities to the Gov-ernor and the General Assembly by December 1, 2017.

HB 1750 – Standing Orders for Naloxone

•Summary: Provides that a pharmacist may dispense naloxone in the absence ofa patient-specific prescription pursuant to a standing order issued by the Commis-sioner of Health authorizing the dispensing of naloxone or other opioid antagonistused for overdose reversal in the absence of an oral or written order for a specific pa-tient issued by a prescriber and in accordance with protocols developed by the Boardof Pharmacy in consultation with the Board of Medicine and the Department of Health. HB 2163/SB 1178 - Limitations on Prescribing Mono-Buprenorphine

•Summary: Provides that prescriptions for products containing buprenorphinewithout naloxone shall be issued only (i) for patients who are pregnant, (ii) when con-verting a patient from methadone to buprenorphine containing naloxone for a periodnot to exceed seven days, or (iii) as permitted by regulations of the Board of Medicineor the Board of Nursing.

Legislative UpdateHunter Jamerson, JD, MBAGeneral Counsel & Legislative Consultant

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HB 2167 – Mandatory Regulations for Prescribing of Opioids

•Summary: Directs the Boards of Dentistry and Medicine to adopt regulationsfor the prescribing of opioids and products containing buprenorphine. The bill requiresthe Prescription Monitoring Program at the Department of Health Professions to pro-vide an annual report to the Joint Commission on Health Care on the prescribing ofopioids and benzodiazepines in the Commonwealth.

•Note: VAFP was successful in lobbying to avoid codification of opioid prescribingstandards. The Board of Medicine has taken emergency regulatory action and contin-ues to revise its draft permanent regulations.

HB 2209/SB 1561 - Emergency Department Care Coordination Program

•Summary: Establishes the Emergency Department Care Coordination Programin the Department of Health to provide a single, statewide technology solution thatconnects all hospital emergency departments in the Commonwealth to facilitate real-time communication and collaboration between physicians, other health careproviders, and other clinical and care management personnel for patients receivingservices in hospital emergency departments, for the purpose of improving the qualityof patient care services.

•Note: VAFP succeeded in advancing this legislation to improve care coordinationand to ensure family medicine providers receive necessary information about patients’ER utilization.

HB 1688 – Commercial Driver License Evaluations by Chiropractors

•Summary: Provides that the practice of chiropractic medicine shall include per-forming the physical examination of an applicant for a commercial driver's license orcommercial learner's permit if the practitioner has (i) applied for and received a cer-tificate as a medical examiner from the Federal Motor Carrier Safety Administrationin accordance with 49 C.F.R. Part 390, Subpart D and (ii) registered with the NationalRegistry of Certified Medical Examiners. The bill also provides that it shall be unpro-fessional conduct for any person to perform the services of a medical examiner as de-fined in 49 C.F.R. § 390.5 if, at the time such services are performed, the personperforming such services is not listed on the National Registry of Certified Medical Ex-aminers or fails to meet the requirements for continuing to be listed on the NationalRegistry of Certified Medical Examiners.

•Note: VAFP succeeded in limiting the scope of this bill to a narrowly tailored pro-vision for commercial driver license exams that is consistent with 41 other states andfederal law.

SB 1230/HB 2165 – E-Prescribing of Opiates

•Summary: Requires a prescription for any controlled substance containing anopiate to be issued as an electronic prescription and prohibits a pharmacist from dis-pensing a controlled substance that contains an opiate unless the prescription is issuedas an electronic prescription, beginning July 1, 2020. A workgroup will be convenedto identify resources needed to implement this e-prescribing requirement.

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SB 1232 - PMP Check Requirements.

•Summary: Requires a prescriber registered with the Prescription MonitoringProgram to request information about a patient from the program upon initiating anew course of treatment that includes the prescribing of opioids anticipated, at theonset of treatment, to last more than seven consecutive days and exempts the pre-scriber from this requirement if the opioid is prescribed as part of treatment for a sur-gical or invasive procedure and such prescription is for no more than 14 consecutivedays. The bill extends the sunset for this requirement from July 1, 2019, to July 1, 2022.

SB 1327 – Doctors of Medical Science

•Summary: Establishes criteria for license as a doctor of medical science and es-tablishes the Advisory Board on Doctors of Medical Science. This legislation wouldallow physician assistants a pathway to independent practice on par with doctors ofmedicine and osteopathy.

•Note: VAFP succeeded in defeating this legislation this year. The concept hasbeen referred for study during the interim. It is likely this bill will be re-filed next ses-sion.

BUDGET AMENDMENTS:

Item 300 #3c - Emergency Department Care Coordination System

•Summary: This amendment adds $370,000 from the general fund and $3.3 mil-lion from nongeneral funds the second year to develop and implement a single,statewide technology solution that connects all the emergency departments in theCommonwealth to enable real time communication and collaboration between physi-cians, providers and other clinical or care management personnel for patients receiv-ing services in hospital emergency departments for the purpose of improving thequality of patient care services, and lowering costs. The general fund for implementingthis program would be matched with $3.3 million in federal Health Information Tech-nology for Economic and Clinical Health (HITECH) Act funds for a total budget in fiscalyear 2018 of $3.7 million. Implementation of this program is contingent upon the re-ceipt of federal HITECH Act funds. Item 302 #1c - Prescription Drug Monitoring Program Demonstration

•Summary: This amendment adds $250,000 from nongeneral funds the secondyear and language directing the agency to develop and implement a real-time prescrip-tion drug monitoring demonstration program with Medicaid prescribers. The sourceof nongeneral funds is from prescription drug monitoring funds matched with en-hanced federal Health Information Technology for Economic and Clinical Health(HITECH) Act funds. Language requires the Department of Medical Assistance Servicesto apply for up to $225,000 in federal HITECH Act funds. Language requires the De-partment of Health Professions to report on increased use of the PMP by prescribersin the demonstration program by July 1, 2018. Language makes the program contin-gent on the receipt of federal HITECH funds.)

Legislative Update (CONTINUED)

Item 288 #1c – Physician Loan Repayment Fund

•Summary: This amendment adds $300,000 from the general fund the secondyear to restore funding for the Virginia State Loan Repayment Program that was elim-inated in the Governor's Fy 2017 Savings Plan and House Bill 1500, as introduced.Funding for the program is matched by the federal government to provide student loanrepayment on behalf of qualified medical, dental, behavioral health and pharmaceutical(pharmacists) professionals who practice at an eligible site in one of the federally des-ignated Health Professional Shortage Areas in Virginia. There are currently 16 indi-viduals on the waiting list for this program.Looking toward 2018… VAFP is actively preparing for the 2018 General Assembly session. Mid-level scope ofpractice is expected to be a primary focus with autonomous practice legislation likelyto be advanced by nurse practitioners and academic institutions promoting advancedpractice physician assistants. Additionally, VAFP continues to work closely with theBoard of Medicine to establish permanent evidence-based opioid regulations. VAFPalso continues to work with the Department of Medical Assistance Services to imple-ment major reforms to the Medicaid program, including a new dual-eligible programand a reformed mothers and children program. And VAFP continues to work with theVirginia Department of Health to improve health care information technology and carecoordination.

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VAFP Career Center

The VAFP Career Center is the hub for physician employment opportunities inVirginia and is the premier member resource to explore employment opportunities inVirginia or to recruit for open positions within your practice. The VAFP has discountedrates for members that want to advertise open positions within the Career Center. To access the Career Center visit www.vafp.org and utilize the Career Center linkon the home page. The VAFP Career Center will provide the opportunity to: Manage Your Career - search and apply to multiple family medicine positionsthat are all located in Virginia, upload your anonymous resume and allow employersto contact you through the Career Center's messaging system, set up job alerts speci-fying your skills, interests, and preferred location(s) to receive email notificationswhen a job is posted that matches your criteria. Recruit for Open Positions - promote your jobs directly to VAFP members viathe exclusive Career Center email system, search the anonymous resume database tofind qualified candidates, manage your posted jobs and applicant activity easily on thisuser-friendly site. One of the goals at the VAFP is to provide members with training and tools to ad-vance their career development. Please utilize the VAFP Career Center to find or fill ajob in the future. If you have any questions, please do not hesitate to contact the VAFPat 1-800-THE-VAFP or e-mail Matt Schulte at mschulte@vafp.org.

Membership

The Virginia Academy of Family Physicians membership continues to increaseannually. As of May 2017, total VAFP membership stood at 3,408 which is an increaseyear to date. Active membership totaled 1,975, resident membership stands at 199and student membership totaled 960, also an increase year to date. Four additionalcategories including Life membership totaled 274. The VAFP continues to offer multiple member benefits including access to theDaily POEMS, the VAFP Career Center and legal resources for employment contractnegotiations. Daily POEMs (Patient Oriented Evidence that Matters) from Essential EvidencePlus provide members with complimentary daily alerts and over 3,000 archivedPOEMs to help members stay abreast of the latest and most relevant medical literature.Delivered directly to by e-mail every Monday through Friday, Daily POEMs identify themost valid, relevant research that may change the way physicians practice. Since 1996,POEMs editors review more than 1,200 studies monthly from more than 100 medicaljournals, presenting only the best and most relevant as POEMs. The acclaimed POEMsprocess applies specific criteria for validity and relevance to clinical practice. The VAFP Career Center is housed on the VAFP website and is the career hub forphysician employment opportunities in Virginia. The VAFP Career Center is the pre-mier resource for you to explore employment opportunities in Virginia or to recruitfor open positions within your practice. The VAFP has discounted member rates forthose that want to advertise open positions within the VAFP Career Center. The VAFP’s General Counsel, Hunter Jamerson, JD, MBA, continues to partner withthe VAFP to provide a legal resource for flat fee physician employment contract reviewand negotiations. This service was developed in 2016 by the VAFP’s General CounselK. Marshall Cook, JD and is invaluable to those physicians that are beginning theirpractice of family medicine after residency completion or those members that arechanging employers or hiring partner physicians. For information on all of these member benefits, please contact the VAFP atadmin@vafp.org or 1-800-THE-VAFP.

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VAFP Awards

Congratulations to the recipients of this year’s VAFP Awards. Included in each registrant’s conference booklet is information on how to nomi-nate your peers for the 2018 VAFP Awards, The VAFP respectfully requests membersto nominate a fellow family physician for one of these outstanding awards. The 2017 Awards will be presented during the Installation of VAFP Officers & Di-rectors and Academy Awards Dinner on Friday, July 21. Congratulations again to eachof the recipients!!

Virginia Family Physician of the Year Award

Daniel M. Jannuzzi, MDJenCare Senior Medical CenterRichmond

James P. Charlton, MD Teacher of the Year Award

Christine C. Matson, MD, FAAFPChairDepartment of Family and Community MedicineEastern Virginia Medical SchoolNorfolkF. Elliott Oglesby, MD Volunteer of the Year Award

Thomas M. Hubbard, MD, DDSVirginia Physicians, Inc.Ashland Medical CenterAshland

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Finances

The Virginia Academy of Family Physicians continues its tradition of operatingunder sound financial management. This effort is led by VAFP Treasurer Dena Hall,MD and the members of the VAFP Executive/Finance Committee. The committeemeets each year to develop an operating budget that meets the needs of the Academyyet is very mindful of the fiscal responsibility to the Academy. The VAFP’s dues are the second lowest in the country as compared to other AAFPChapters with an active membership of similar size. Additionally, the VAFP has hadonly three dues increases in the last 27 years. Net income for fiscal year 2016 was $182,962. This is significant given the finan-cial impact of the reduction of outside grant income, challenging exhibit sales and com-petition from other educational offerings. Of special importance is that Support and Revenue for the VAFP resulted in an in-crease in dues revenue and CME meeting revenue. This is especially important in thatthe VAFP’s expenses including both Program Services and Supporting Services re-mained essentially the same compared to fiscal year 2015. Of equal importance, theVAFP ended fiscal year 2016 with Unrestricted Net Assets of just over $1,500,000 andTotal Assets of just over $1,900,000.

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Finances—Statement Of FinancialPosition & Activities

FOR THE YEAR ENDING DECEMBER 31, 2016SUPPORT AND REVENUEMembership dues $ 570,355Annual Meeting $ 192,281CME seminars $ 188,704Interest income $ 22,901Career Center $ 8,386Other $ 8,195Total support and revenue $ 990,822ExPENSESProgram services $ 355,624Supporting services $ 450,815Loss of Disposition of Assets $ 1,421Total expenses $ 807,860Unrestricted Net Assets, beginning of year $1,347,756Increase in unrestricted net assets $ 182,962Unrestricted Net Assets, end of year $1,530,718ASSETSCURRENT ASSETSCash and cash equivalents $1,785,957Accounts receivable $ 120,299Prepaid expenses $ 12,805Total current assets $1,919,061PROPERTy AND EQUIPMENTOffice furniture and equipment $ 43,048Accumulated depreciation $ (29,839)Net property and equipment $ 13,209Total Assets $1,932,270LIABILITIES AND UNRESTRICTED NET ASSETSCURRENT LIABILITIESAccounts payable $ 346Deferred revenue $ 401,206Total current liabilities and total liabilities $ 401,552Unrestricted Net Assets $1,530,718Total Liabilities and Unrestricted Net Assets $1,932,270

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Continuing Medical Education

The Virginia Academy of Family Physicians continues its tradition of offering firstclass, affordable continuing medical education conferences for Academy members. Each year, the Academy sponsors two major CME activities. The WintergreenWinter Family Medicine Weekend is held over four days in the winter months of Jan-uary or February annually. This year the conference drew over 225 family physicians,residents, medical students, and other health care professionals. The exhibit portionof the conference was comprised of 39 exhibiting organizations - the maximum num-ber available - and was sold out months in advance of the meeting. The Academy’s Annual Meeting & Exposition is held each summer. This year’sconference is taking place July 20-23, 2017 at the Lansdowne Resort & Spa in Leesburg.Academy members will have the opportunity to enjoy all of the activities that the resortand area offer. Approximately 60 exhibiting organizations will be available to discusswith members the newest in product and service developments. CME costs for Acad-emy members’ average $13.00 per credit hour. The VAFP sponsored numerous group learning sessions to assist VAFP memberswith the completion of their ABFM Family Medicine Certification Process require-ments. Knowledge Self-Assessment (KSA) and Clinical Self-Assessment (CSA) pro-grams were held during 2016 and the first half of 2017. Maintenance of Certificationsessions are being held in conjunction with this year’s Annual Meeting and there arefour more scheduled for the remainder of 2017. These sessions drew maximum at-tendance and continue to be evaluated very highly. Continued in 2017, the Part IV Performance in Practice Module: Critical Thinkingfor Quality Improvement in Critical Care Session is designed to help physicians im-prove clinical critical thinking and quality improvement skills. Both of these skills ben-efit all clinicians, regardless of practice setting, and help improve clinical practiceperformance. Additionally, this module benefits physicians who are not in active clin-ical practice but are involved in healthcare decision-making, as the ability to think crit-ically about medical questions is relevant in all healthcare-related settings. The Academy expresses its deep appreciation to the Chair of the Continuing Med-ical Education Committee, Mitchell B. Miller, MD, FAAFP and his committee for theiroutstanding work in creating superb CME for VAFP members and to Kurtis S. Elward,MD, MPH, FAAFP, Mark H. Greenawald, MD, FAAFP, Christine Matson, MD, FAAFP, andMargaret Baumgarten, MD for their exceptional work as Family Medicine CertificationSession presenters.

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Practice Enhancement & QualityCommittee ReportAnton J. Kuzel, MD, MHPE, FAAFP &Kurtis S. Elward, MD, MPH, FAAFPThe Heart of Virginia Healthcare cooperative has retained 220 practices and, as ofAugust, will complete the support phase for each cohort of practices. There are manystories of practices finding that the strategies the coaches and faculty suggested haveimproved their workflow, reduced practice stress, and allowed them to pay systematicattention to cardiovascular risk factor reduction. The baseline paper reporting initialresults will be in a special issue of the Annals of Family Medicine (along with the othersix cooperatives and the national evaluation team.) A major issue to overcome wasthe difficulty in getting accurate cardiovascular measures out of the 24 varieties ofEMRs among participating practices. These EMRs were all certified, but their func-tionality for population health and quality improvement was not nearly as robust asassumed. In the coming year, more information about what differences the supportmade in the practices will be available. In addition, several qualitative case studies tounderstand why some practices succeeded even in challenging community environ-ments, while other did not will be conducted.

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Emerson D. Baugh, Jr, MDKenbridgeVAFP Past PresidentS. Lynn Broadfield, MDSpotsylvaniaFrank A. Carroll, MDAlexandriaK. Marshall Cook, Esq.Manakin-SabotVAFP General CounselThomas P. Davis, MDChristiansburgVAFP Past PresidentRichard W. Elsea, MDChurchvilleJames G. Evans, MDBath

William S. Grabeel, MDGordonsvillePeter S. Ham, MDCharlottesvilleMartin Lerner, MDSuffolkRonald E. Miller, MDHopewellWilliam K. Orr, MDFishersvilleFrancis J. Stenicka, MDPortsmouthMaurice Wood, MDNellysford

In Memoriam

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Residents & Students

The Virginia Academy of Family Physicians Board of Directors has one residentrepresentative and one medical student representative who serve on the Board on arotating basis. Representatives are chosen on a rotating basis by their peers from asubcommittee of residents and students representing all the schools and residencyprograms in Virginia. These subcommittees meet by phone, have their own VAFP listserve, and gather for an in-person meeting during the Wintergreen conference. TheVAFP provides funding for one resident and student to attend each VAFP Board meet-ing. The VAFP provides complimentary housing for students and residents to attendthe VAFP Winter Family Medicine Weekend held annually at Wintergreen Resort. Atthe 2017 VAFP Winter Family Medicine Weekend, 14 Family Medicine Residents and45 medical students were in attendance. In addition, the medical students are offereda student specific educational session at Wintergreen focused on Clinical Decision Mak-ing. It is a case-based discussion of the process of clinicaldecision making and the challenges and pitfalls physicians face while developing dif-ferential diagnoses and working to establish a final diagnosis. The VAFP also supports residents with discounted employment contract reviewby the VAFP’s General Counsel and a Career Center that houses multiple job offeringsin the Commonwealth. The VAFP supports the Family Medicine Interest Group’s ateach of the six Virginia medical schools with $500.00 in funding to develop programsthat promote Family Medicine. The VAFP Foundation offers a graduating medical student that attends a VirginiaResidency Program a $1,000 scholarship as well as a Virginia PGy-3 Graduating Resi-dent a $1,500 scholarship that chooses to practice in an underserved area of Virginia.The Foundation awarded its first scholarships in 2017. Academy dues are paid by the VAFP for resident members in their first year ofresidency and all medical student dues are complimentary.

VAFP Past Presidents

*William L. Powell, MD, Roanoke 1947-48*James L. Hamner, MD, Mannboro 1948-49*James D. Hagood, MD, Clover 1949-50*Ira L. Hancock, MD, Virginia Beach 1950-51*John O. Boyd, Jr., MD, Roanoke 1952-52 *Edward S. Haddock, MD, Richmond 1952-53*Brewster A. Hopkins, MD, Stuart 1953-54*Richard M. Reynolds, MD, Norfolk 1954-55*Rufus Brittain, MD, Tazewell 1955-56*Frank E. Tappan, MD, Berryville 1956-57*Malcolm H. Harris, MD, West Point 1957-58*W. Linwood Ball, MD, Richmond 1958-59*Fletcher J. Wright, Jr., MD, Petersburg 1959-60*Boyd H. Payne, MD, Staunton 1960-61*William J. Hagood, MD, Clover 1961-62*Harry M. Frieden, MD, Norfolk 1962-63*Frank D. Daniel, MD, Lynchburg 1963-64*Thomas L. Lucas, MD, Charleston, SC 1964-65*Russell G. McAllister, MD, Richmond 1965-66*Robert L. Cassidy, MD, Culpeper 1966-67J. Powell Anderson, MD, Waynesboro 1967-68*Howard I. Kruger, MD, Norfolk 1968-69*A. Epes Harris, MD, Blackstone 1969-70Clarence W. Taylor, Jr., MD, Shawsville 1970-71*Thomas H. Jennings, MD, Bedford 1971-72*Alan Mackintosh, MD, Bristow 1972-73T. Winston Gouldin, MD, Norfolk 1973-74William B. Waddell, MD, Galax 1974-75*Robert S. Smith, MD, Richmond 1975-76*Levi W. Hulley, Jr., MD, Richmond 1976-77George Robert Smith, MD, Shawsville 1977-78*Emerson D. Baugh, Jr., MD, Kenbridge 1978-79Gene E. Clapsaddle, MD, Moneta 1979-80Harold M. Horden, MD, Norfolk 1980-81*James P. Charlton, MD, Virginia Beach 1981-82*Benjamin E. Norfleet, MD, Newport News 1982-83

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VAFP Past Presidents

J. Francis Amos, MD, Rocky Mount 1983-84G. Stanley Mitchell, Jr., MD, Newport News 1984-85*F. Elliott Oglesby, Sr., MD, Richmond 1985-86Alvin J. Ciccone, MD, Norfolk 1986-87*Robert F. Baxter, MD, Grundy 1987-88J. Albert Hagy, MD, Roanoke 1988-89Harold W. Markham, MD, Virginia Beach 1989-90Leroy S. McDaniel, MD, Richmond 1990-91*T. P. Davis, MD, Christiansburg 1991-92*Charles H. Crowder, Jr. MD, South Hill 1992-93Stuart M. Solan, MD, Richmond 1993-94J. Michael Ponder, MD, Franklin 1994-95Roger A. Hofford, MD, Lynchburg 1995-96Michelle Whitehurst-Cook, MD, Highland Springs 1996-97Mitchell B. Miller, MD, Virginia Beach 1997-98Larry G. Mitchell, MD, Richlands 1998-99David A. Ellington, MD, Lexington 1999-00J. Douglas Smith, MD, Harrisonburg 2000-01Joseph Leming, MD, Colonial Heights 2001-02Shane J. Kraus, MD, Glen Allen 2002-03Cynthia C. Romero, MD, Virginia Beach 2003-04Dena R. Hall, MD, Suffolk 2004-05Kurtis S. Elward, MD, MPH, Charlottesville 2005-06Wayne J. Reynolds, DO, Gloucester Point 2006-07Sterling N. Ransone, Jr, MD, Deltaville 2007-08 E. Mark Watts, MD, Vinton 2008-09Janice E. Ragland, MD, Herndon 2009-10Jesus L. Lizarzaburu, MD Grafton 2010-11Kent E. Willyard, MD, Newport News 2011-12Mark H. Greenawald, MD, Roanoke 2012-13Sean Reed, MD, Charlottesville 2013-14Robert I. Elliott, MD, Hurt 2014-15Charles O. Frazier, MD, Williamsburg 2015-16* Deceased

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